RPT-Poll: Americans have mixed feelings about healthcare

October 05, 2012|Reuters

(Repeats from Oct 3)

By Gabriel Debenedetti

Oct 3 (Reuters) - It's no secret that 2010's Affordable CareAct is unpopular - except when it's not. Reuters/Ipsos pollingreveals a remarkably high level of approval for nearly all theprovisions of the act, often in the 80 percent range, eventhough respondents oppose the legislation, commonly known as"Obamacare," by 55 to 45. Remarks made during the Oct. 3presidential debate added confusion rather than clarity to thehealthcare issue.

Polled in midsummer, shortly after the Supreme Court upheldmost of the ACA law, almost two-thirds of respondents favoredallowing those under the age of 26 to keep their parents'coverage. Eighty-two percent supported a ban on denying coveragebecause of preexisting conditions, and 86 percent agreedcompanies should not be allowed to cancel policies when theowners become ill.

Similarly, 80 percent favored the creation of insurancepools and a ban on the lifetime healthcare cost cap. Almost 70percent supported regulating private insurance companies to makesure they offer comparable coverage.

Despite Republican grumbling about how the changes couldharm businesses and the economy, almost three-quarters ofrespondents favored requiring companies with 50 or moreemployees to provide coverage. All these provisions are part ofACA, although some of them do not take effect until 2014.

How such popular measures became the Achilles' heel of theObama administration - only 21 percent strongly approved of thepresident's handling of healthcare in a September poll, while 34percent strongly disapproved - can be traced to a single term:"the individual mandate."

The requirement that all citizens obtain healthcare coveragewas opposed by 59 percent of respondents in the summer poll andhas been lambasted by critics as a step toward "socializedmedicine" and a "welfare state." Yet more than 53 percent ofrespondents strongly agreed that all Americans have a right tohealthcare. A substantial 75 percent support subsidies to helpthe poor pay for health insurance, and 64 percent are in favorof expanding Medicaid to families with incomes under $36,000.

MESSAGING PROBLEMS?

Architects of the ACA understood that unless everyone iscovered the insurance risks cannot be spread broadly enough tomake healthcare affordable - that you cannot have the popularfeatures without the mandate. "No one is over the moon about themandate, but it is necessary to provide those provisions peopleneed and support," a Democratic official in Ohio said. But didit fail to adequately explain this in selling ACA?

In July, Obama told CBS News his first term's biggestmistake was prioritizing policy far above messaging. A versionof this criticism has been one of the most persistent knocks onObama's tenure from the left.

Jonathan Gruber, a Massachusetts Institute of Technologyeconomics professor who advised the White House on theAffordable Care Act as well as Massachusetts on the law enactedby Governor Mitt Romney in 2006 doesn't buy it. "I spend a lotof time trying to critique moves made by the general manager ofthe Red Sox. But at the end of the day, he's better at this thanI am," he said. "It's the same thing with Obama. If there was aneasy, good message, they would have found it."

Paul Starr, a Princeton University professor who advisedPresident Bill Clinton on his healthcare policy, said the law'stiming has also hindered its popularity. "I know people all thetime blame the messenger, but the particular problem this timehas been the extraordinary delay in implementation," he said.

"Until people actually see how this works in practice, theyare going to be susceptible to all kinds of fears about it, andwon't have a very clear idea about what it is."

The individual mandate was also a central feature ofGovernor Mitt Romney's 2006 h ealthcare reform in Massachusetts,which continues to enjoy broad support. B ut as a candidate forpresident, Romney appears to believe that you can expandcoverage without getting everyone insured: Although he has vowedto overturn ACA "on day one," he has also said he supports someof its popular features, and reaffirmed in Wednesday's debatethat he would prohibit discrimination against preexistingconditions.

But a Romney campaign official explained that this willapply only to "people who have maintained continuous coverage."He added that Romney supports giving states the flexibility andresources to craft programs that will assist those who cannotafford coverage on their own to obtain access to the care theyneed."

In July, 57 percent of respondents said the Americanhealthcare system is headed in the wrong direction, but only 29percent preferred Mitt Romney's plan for healthcare. Forty-onepercent preferred Obama's approach, despite the dramaticambivalence about ACA.